What is VO2 max and why does it matter for longevity?

VO2 max is the maximum amount of oxygen your body can use during intense exercise. It is the single most validated predictor of cardiovascular fitness, endurance capacity, and long-term mortality risk. Higher VO2 max is associated with lower cardiovascular mortality, better metabolic health, and enhanced cognitive resilience as you age — making it one of the highest-ROI measurements in longevity medicine. Research consistently shows that individuals in the top quartile of VO2 max for their age have dramatically lower all-cause mortality than those in the bottom quartile.

What equipment does Makena Health use for VO2 max testing?

Makena Health uses the COSMED QNRGplus, an industry-leading metabolic testing system with gold-standard accuracy validated against research-grade methods. Testing is available on both a treadmill and a resistance bike, allowing sport-specific and joint-appropriate assessment.

What will I learn from a VO2 max test?

You will leave with your VO2 max score, fat max zone, and personalized heart rate training zones. The test also provides insight into fat versus carbohydrate utilization (metabolic flexibility), your cardiovascular biological age relative to population norms, precise daily caloric requirements, and early indicators of metabolic dysfunction that may not yet appear in standard lab work.

How much does VO2 max testing cost at Makena Health?

For non-members: $250 for the first visit, $200 for return visits. For Makena Health members: $187.50 for the first visit, $150 for return visits.

How long does a VO2 max test take?

Testing takes 30 to 40 minutes. You will wear athletic clothing and appropriate footwear and perform a progressive exercise protocol on either the treadmill or resistance bike while breathing through a metabolic mask connected to the COSMED system. Results are reviewed with you after the test.

Who should get VO2 max testing?

VO2 max testing is particularly valuable for high performers optimizing endurance and recovery, individuals struggling with fat loss despite consistent effort, patients interested in longevity and cardiometabolic risk reduction, athletes seeking precise training zone data, and anyone who wants objective data on their metabolic health rather than estimates from wearables or age-based formulas.

Do I need to be a member to get VO2 max testing at Makena Health?

No. VO2 max testing is available to non-members as a standalone service at $250 for the first visit. Members receive a discounted rate of $187.50.

Makena Health | Concierge & Longevity Medicine in Maui, Hawaii

VO₂ Max & Metabolic Testing in Maui

Know Exactly How Your Body Performs and Burns Energy

At Makena Health, we provide clinical-grade VO₂ max and metabolic testing in Maui using gold-standard indirect calorimetry. Unlike wearables or estimates, this is direct measurement of your physiology.

We test on both a treadmill and resistance bike, allowing precise, sport-specific assessment of your cardiovascular fitness, metabolic efficiency, and training zones.

→ Book Your Test
→ Optimize Your Performance and Longevity

VO₂ max testing measures the maximum amount of oxygen your body can utilize during exercise. It is the single most validated predictor of cardiovascular fitness, endurance capacity, and long-term mortality risk.
At Makena Health, we perform VO₂ max testing using:
- Treadmill protocols for runners and general fitness
- Resistance bike protocols for cyclists and joint-friendly assessment
This allows us to tailor testing to your physiology, injury history, and performance goals.
Equipment: COSMED VO₂ systems are considered the industry standard due to their gold-standard accuracy and validation against research-grade metabolic testing methods, delivering highly precise, clinically reliable data.
Your Resting Metabolic Rate (RMR) or Resting Energy Expenditure (REE) is the number of calories your body burns at rest to sustain life.
We measure this using indirect calorimetry, providing:
- Precise daily caloric needs
- Insight into metabolic efficiency
- Data to guide fat loss, muscle gain, and hormone optimization
No more relying on formulas or wearable guesses.
Most facilities offer fragmented or fitness-only testing. We take a physician-led, integrative approach:
- Clinical-grade metabolic cart (not consumer devices)
- Dual modality testing: treadmill + resistance bike
- Full analysis of VO₂ max, RER, ventilatory thresholds, and substrate utilization
- Integration into a comprehensive medical and longevity plan
This is not just data collection. It is clinical interpretation and strategic application.
Your testing provides actionable insights into:
- Cardiovascular fitness and biological age
- Fat vs carbohydrate utilization (metabolic flexibility)
- Optimal heart rate training zones
- Caloric requirements for fat loss or performance
- Early metabolic dysfunction before lab abnormalities
- High performers optimizing endurance and recovery
- Individuals struggling with fat loss despite “doing everything right”
- Patients interested in longevity and cardiometabolic risk reduction
- Athletes seeking precise training zone data
- Anyone tired of guessing their metabolism
VO₂ max is one of the strongest predictors of lifespan ever studied. Higher levels are associated with:
- Lower cardiovascular mortality
- Improved metabolic health
- Enhanced cognitive resilience
Improving VO₂ max is one of the highest ROI interventions in longevity medicine.
Most people dramatically misestimate their caloric needs. This leads to:
- Plateaus in fat loss
- Loss of lean muscle
- Hormonal dysregulation
Measured RMR eliminates this guesswork and allows precision nutrition strategies.

A person running along a waterfront promenade during sunset, with city skyline in the background and trees framing the scene.

Work With Us

Stop Guessing. Start Measuring.

Your metabolism and performance are too important to leave to estimates.

→ Schedule VO₂ Max & Metabolic Testing in Wailea
→ Get a Personalized Performance & Longevity Plan

This therapy is part of our comprehensive Longevity Medicine Program at Makena Health.

VO2 max, RMR/REE, and related metabolic testing on this page measure current physiological performance and are used by Dr. Starbuck alongside your broader clinical picture to guide training, nutrition, and longevity planning. Terms like biological age reflect a research framework for comparing physiological markers to population norms, not a clinical diagnosis. These tests are not intended to diagnose, treat, cure, or prevent any disease, and results vary based on effort, equipment, and individual physiology. These statements have not been evaluated by the FDA.

VO₂ Max & Metabolic Testing in Maui

What Is VO₂ Max Testing?

What Is RMR / REE Testing?

What Makes Our Testing Different?

What You'll Learn?

Who Benefits from VO₂ Max & RME/REE Testing?

Why VO₂ Max Matters for Longevity

Why RMR / REE Testing Matters